Factor V Leiden: Treatment


Most common hereditary hypercoagulable state: 4-8% population

  • Gene causes change in Factor V protein making it resistant to inactivation by protein C –> increased propensity to clot by increased Factor V concentrations in blood
  • Long term homozygotes for Factor V Leiden will receive anticoagulation
  • Must weigh risks of anticoagulation vs risk thrombosis
  • Treatment length depends on circumstances of thrombosis
  • High risk: Lifelong anticoagulation
  • 2 or more spontaneous thrombosis or 1 spontaneous thrombosis in setting of AT3 deficiency or antiphospholipid syndrome
  • 1 spontaneous thrombosis that is life threatening or at an unusual site
  • 1 spontaneous thrombosis with >1 genetic defect predisposing to thromboembolic even
  • Long term anticoagulation: those with inherited thrombophillia
  • 3-6 months
  • Maintain INR 2-3


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